The Spoon Theory and Pacing

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You may have heard people refer to themselves as “Spoonies”, or say they “have run out of spoons”. So what does this mean?

“The Spoon Theory” was created by Christine Miserandino in 2003 in her essay of the same name. Christine has lupus, which is an invisible illness that can cause a variety of debilitating symptoms. Christine used spoons as a stand-in for units of energy. They model how activities can be difficult and costly to people with chronic illness. Each task cost a ‘spoon’, and someone with chronic illness starts with only a limited number per day. There is no way to start with more, and trying to ‘buy’ extra ‘spoons’ can end up causing further problems. This helped Christine’s friend to understand that people with chronic illness have to plan out their activities carefully. Unexpected tasks might mean they cannot do other things due to having limited ‘spoons’. The full essay is here.

The Spoon Theory can be a useful way of describing your experience to people around you. It can also be helpful for self care. Thinking about how many spoons you have each day (which may not be consistent), how many spoons will be needed for various tasks (which, again, may not be consistent) and planning out activities within those limits is known as “pacing”.

Pacing is a self-directed way of managing illness and fatigue that is personal to you. It means getting to know your abilities and responses to certain stimuli. This helps you to organise your time and activities. It is all about balance – not cramming everything in first thing in the hope that you can rest later!

Perhaps one of the most tricky aspects to pacing is the self-discipline needed. It is very easy to think, “I’ve only got this thing to do, I’ll just push through and rest later!” even if that will result in a much longer recovery time. You might also struggle with feelings of embarrassment if you need to stop an activity right in the middle, or fear letting people down. I’ve written several times before about saying “no”.

Pacing isn’t an easy or quick thing to arrange, but it can be very helpful. Long-term, pacing activities may be much better for your health than ‘soldiering on’. Action for M.E. has produced a wonderful booklet that explains pacing, the evidence base for it and how to use it. The booklet can be found online here.

Illnesses such as CFS/ME, fibromyalgia, EHS and lupus are very real, not just “in your head”. This means counselling cannot ‘cure’ them. However, these illnesses and their symptoms can cause, and also be made worse by, mental issues such as stress, anxiety and depression. You may need to work through your grief or fear around your diagnosis, and get support in working out how to live your best life within these limits. If you would like to make an appointment, please contact me.